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Patellar resurfacing in total knee replacement: a ten-year randomised prospective trial
D G Campbell1, W W Duncan, M Ashworth
1The Queen Elizabeth Hospital, Woodville, Adelaide, South Australia. dcampbell@woc.com.au
Summary
Routine patellar resurfacing in total knee replacement for osteoarthritis did not show significant benefits. Long-term follow-up revealed no difference in knee function or complications between resurfaced and non-resurfaced patellae.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
- Rheumatology
Background:
- Osteoarthritis frequently affects the knee joint, necessitating total knee replacement (TKR).
- The role of patellar resurfacing during TKR in osteoarthritic patients remains a subject of clinical debate.
- Optimizing TKR outcomes requires evaluating the impact of patellar component management.
Purpose of the Study:
- To compare the long-term functional outcomes and complications of TKR with and without patellar resurfacing in osteoarthritic patients.
- To assess the effect of patellar component management on knee performance and patient-reported outcomes over ten years.
- To determine if routine patellar resurfacing is warranted in TKR for osteoarthritis.
Main Methods:
- A randomized controlled trial involving 100 osteoarthritic patients undergoing TKR with the Miller-Galante II prosthesis.
- Patients were assigned to either undergo patellar resurfacing or not.
- Knee function was assessed using the American Knee Society (AKS) score, Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and radiographic evaluation up to 4 years, followed by questionnaires up to 10 years.
Main Results:
- No significant difference in AKS scores or WOMAC scores was observed between the patellar resurfacing and non-resurfacing groups at ten years.
- Both groups exhibited similar deterioration of functional scores over time.
- No additional patellofemoral complications were noted in either treatment group during the follow-up period.
Conclusions:
- Routine patellar resurfacing in osteoarthritic patients undergoing total knee replacement is not recommended based on these findings.
- The study suggests that patellar management during TKR for osteoarthritis does not significantly alter long-term outcomes or complication rates.
- Further research may be needed to identify specific patient subgroups who might benefit from patellar resurfacing.
